Rosacea

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Definition

Rosacea is a chronic skin condition involving inflammation of the cheeks, nose, chin, forehead, or eyelids. It may appear as redness, prominent spider-like blood vessels, swelling, or skin eruptions similar to acne.

Alternative Names

Acne rosacea

Causes, incidence, and risk factors

Although the cause of rosacea is unknown, you are more likely to develop this harmless skin condition if:

You are fair-skinned
You blush easily
You are a woman (however, men with the condition are usually more severely affected)
You are between the ages of 30 and 50

Rosacea involves swelling of the blood vessels just under the skin. It may be associated with other skin disorders (acne vulgaris, seborrhea) or eye disorders (blepharitis, keratitis).

Symptoms

Redness of the face in discrete areas or covering the entire face
A tendency to flush or blush easily
Increased number of spider-like blood vessels (telangiectasia) of the face
A red, bulbous nose
Acne-like skin eruptions (may ooze or crust)
A burning or stinging sensation of the face
Irritated, bloodshot, watery eyes

Signs and tests

Your physician can usually diagnose rosacea with a thorough medical history and physical exam.

Treatment

There is no known cure for rosacea. The goal is to identify and avoid possible triggers, and thus reduce flare-ups. By keeping a symptom diary to identify the specific triggers you may have, you may be able to see a pattern of what makes your rosacea worse. Use this information to avoid future flare-ups.

Here are some steps that may help:

Avoid sun exposure. Use sunscreen every day.
Avoid prolonged exertion in hot weather.
Try to reduce stress. Try deep breathing, yoga, or other relaxation techniques.
Limit spicy foods, alcohol, and hot beverages.

Triggers vary from person to person. Other triggers may include wind, hot baths, cold weather, specific skin products, exercise, or other factors.

Antibiotics taken by mouth (such as tetracycline, minocycline, or doxycycline) or applied to the skin (such as metronidazole) may control skin eruptions. Other medications (isoretinol or Accutane), which are similar to vitamin A, are stronger alternatives that your doctor or dermatologist might consider. Rosacea is not acne and will not improve with over-the-counter acne treatment.

In severe cases, laser surgery may help reduce the redness. Surgical reduction of enlarged nose tissue may also improve your appearance, if you so choose.

Support Groups

Expectations (prognosis)

Rosacea is not medically dangerous. It is not curable, but can usually be controlled with treatment. It may be persistent and chronic.

Complications

Permanent changes in appearance (for example, a bulbous nose)
Psychological damage, loss of self esteem

Calling your health care provider

Prevention

References

Habif TP. Acne, rosacea, and related disorders. In: Habif TP, ed. Clinical Dermatology. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 7.

Goldgar C, Keahey DJ, Houchins J. Treatment Options for Acne Rosacea. Am Fam Phys. 2009 Sep;80(5).

van Zuuren EJ, et al. Systematic review of rosacea treatments. J Am Acad Dermatol. 2007:56(1):107-115

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